Category Archives: Dairy Products

Do you ever wonder how many of your total calories come from added sugars? Grains? Dairy products? Added fats?

Deriving your personal numbers would require detailed nutrient analysis, but if you’d like U.S. averages, see this cool infographic at Civil Eats.

It also shows how many calories are or were available for consumption per capita over time (without accounting for wastage in restaurants). It’s based on U.S. Department of Agriculture data.

A superficial glance suggests that U.S. per capita daily calorie consumption has increased by about 600 from the 1970s until now. But remember, these numbers don’t discount for restaurant wastage. Nor do I see an adjustment for children versus adults. I’ve seen other calculations of and extra daily 150 calories (women) to 300 calories (men). Even the lower numbers could explain our explosion of overweight and obesity.

Diabetes is a disorder of carbohydrate metabolism. In a way, it’s an intolerance of carbohydrates. In type 1 diabetes, there’s a total or near-total lack of insulin production on an autoimmune basis. In type 2 diabetes, the body’s insulin just isn’t working adequately; insulin production can be high, normal or low. In both cases, ingested carboydrates can’t be processed in a normal healthy way, so they stack up in the bloodstream as high blood sugars. If not addressed adequately, high blood glucose levels sooner or later will poison body tissues . Sooner in type 1, later in type 2. (Yes, this is a gross over-simplification.)

Gluten-rich Neolithic food

If you’re intolerant of lactose or gluten, you avoid those. If you’re intolerant of carbohydrates, you could avoid eating them, or take drugs to help you overcome your intolerance. Type 1 diabetics must take insulin. Insulin’s more optional for type 2’s. We have 11 classes of drugs to treat type 2 diabetes; we don’t know the potential adverse effects of most of these drugs. Already, three diabetes drugs have been taken off the U.S. market or severely restricted due to unacceptable toxicity: phenformin, troglitazone, and rosiglitazone.

Humans need two “essential fatty acids” and nine “essential” amino acids derived from proteins. “Essential” means we can’t be healthy and live long without them. Our bodies can’t synthesize them. On the other hand, there are no essential carbohydrates. Our bodies can make all the carbohydrate (mainly glucose) we need.

Since there are no essential carbohydrates, and we know little about the long-term adverse side effects of many of the diabetes drugs, I favor carbohydrate restriction for people with carboydrate intolerance. (To be clear, insulin is safe, indeed life-saving, for those with type 1 diabetes.)

That being said, let’s think about the Standard American Diet (SAD) eaten by an adult. It provides an average of 2673 calories a day. Added sugars provide 459 of those calories, or 17% o the total. Grains provide 625 calories, or 23% of the total. And most of those sugars and grains are in processed, commercial foods. So added sugars and grains provide 40% of the total calories in the SAD. (Figures are from an April 5, 2011, infographic at Civil Eats.)

Anyone going from the SAD to pure Paleo eating will be drastically reducing intake of added sugars and grains, our current major sources of carbohydrate. Question is, what will they replace those calories with?

That’s why I gave a thumbnail sketch of the paleo diet above. Take a gander and you’ll see lots of low-carb and no-carb options, along with some carb options. For folks with carbohydrate intolerance, I’d favor lower-carb veggies and judicious amounts of fruits, berries, and higher-carb veggies and

Will these cause bladder cancer? Pancreatitis?

tubers. “Judicious” depends on the individual, considering factors such as degree of residual insulin production, insulin sensitivity, the need to lose excess weight, and desire to avoid diabetes drugs.

Compared to the standard “diabetic diet” (what’s that?) and the Standard American Diet, switching to paleo should lower the glycemic index and glycemic load of the diet. Theoretically, that should help with blood sugar control.

A well-designed low-carb paleo diet would likely have at least twice as much fiber as the typical American diet, which would also tend to limit high blood sugar excursions.

In general, I favor a carbohydrate-restricted paleo diet for those with diabetes who have already decided to “go paleo.” I’m not endorsing any paleo diet for anyone with diabetes at this point—I’m still doing my research. But if you’re going to do it, I’d keep it lower-carb. E.g., under 100 g of digestible carb daily. It has a lot of potential.

Are There Any Immediate Dangers for a Person With Diabetes Switching to the Paleo Diet?

It depends on three things: 1) current diet, and 2) current drug therapy, and 3) the particular version of paleo diet followed.

Remember, the Standard American Diet provides 40% of total calories as added sugars and grains (nearly all highly refined). Switching from SAD to a low-carb paleo diet will cut carb intake and glycemic load substantially, raising the risk of hypoglycemia if the person is taking certain drugs.

Who knows about carb content of the standard “diabetic diet”? Contrary to poplular belief, there is no monolithic “diabetic diet.” There is no ADA diet (American Diabetes Association). My impression, however, is that the ADA favors relatively high carbohydrate consumption, perhaps 45-60% of total calories. Switching to low-carb paleo could definitely cause hypoglycemia in those taking the aforementioned drugs.

One way to avoid diet-induced hypoglycemia is to reduce the diabetic drug dose.

A type 2 overweight diabetic eating a Standard American Diet—and I know there are many out there—would tend to see lower glucose levels by switching to probably any of the popular paleo diets. Be ready for hypoglycemia if you take those drugs.

Someone could end up with a high-carb paleo diet easily, by emphasizing tubers (e.g., potatoes), higher-carb vegetables, fruits, berries, and nuts (especially cashews). Compared with the SAD, this could cause higher or lower blood sugars, or no net change.

A diabetic on a Bernstein-style diet or Ketogenic Mediterranean Diet (both very-low-carb) but switching to paleo or low-carb paleo (50-150 g?) would see elevated blood sugars. Perhaps dangerously high glucoses.

Any person with diabetes making a change in diet should do it in consultation with a personal physician or other qualified healthcare professional familiar with their case.

I was recently involved in a discussion in which some folks were attempting to distinguish between what they were calling “processed” cheese and other (presumably non-processed) cheese, without defining what they mean by “processed” cheese. As I think that’s a less than optimal approach, I’d like to take a moment to sketch out why that is so; perhaps increasing, in the process, your enjoyment of cheese forever.

It’s a moderately lengthy article, but well worth it for the amusement and erudition. You’ll learn how cheese is made, starting with the photons.

Cheese is a time-honored component of the traditional Mediterranean diet. That’s one reason I left it in the Ketogenic Mediterranean Diet. If you don’t like cheese but still desire the health benefits of the Mediterranean diet, don’t fret. I’ve not found any important nutrients in cheese that you can’t get elsewhere.

Investigators at the University of Lund found enrolled 38 male heart patients—average age 61—patients and randomized them to either a paleo diet or a “consensus” (Mediterranean-like) diet to be followed for 12 weeks. Average weight was 94 kg. Nine participants dropped out before completing the study, so results are based on 29 participants. All subjects had either prediabetes or type 2 diabetes (the majority) but none were taking medications to lower blood sugar. Baseline hemoglobin A1c’s were around 4.8%. Average fasting blood sugar was 125 mg/dl (6.9 mmol/l); average sugar two hours after 75 g of oral glucose was 160 mg/dl (8.9 mmol/l).

The paleo diet was based on lean meat, fish, fruits, leafy and cruciferous vegetables, root vegetables (potatoes limited to two or fewer medium-sized per day), eggs, and nuts (no grains, rice, dairy products, salt, or refined fats and sugar).

The paleo group ate significantly more nuts, fruit, and vegetables. The Mediterranean group ate significantly more cereal grains,oil, margarine, and dairy products.

Glucose control improved by 26% in the paleo group compared to 7% in the consensus group. The improvement was statisically significant only in the paleo group. The researchers believe the improvement was independent of energy consumption, glycemic load, and dietary carb/protein/fat percentages.

Hemoglobin A1c’s did not change or differ significantly between the groups.

Neither group showed a change in insulin sensitivity (HOMA-IR method).

Comments

The authors’ bottom line:

In conclusion, we found marked improvement of glucose tolerance in ischemic heart disease patients with increased blood glucose or diabetes after advice to follow a Palaeolithic [sic] diet compared with a healthy Western diet. The larger improvement of glucose tolerance in the Palaeolithic group was independent of energy intake and macronutrient composition, which suggests that avoiding Western foods is more important than counting calories, fat, carbohydrate or protein. The study adds to the notion that healthy diets based on whole-grain cereals and low-fat dairy products are only the second best choice in the prevention and treatment of type 2 diabetes.

This was a small study; I consider it a promising pilot. Results apply to men only, and perhaps only to Swedish men. I have no reason to think they wouldn’t apply to women, too. Who knows about other ethnic groups?

This study and the one I mention below are the only two studies I’ve seen that look at the paleo diet as applied to human diabetics. If you know of others, please mention in the Comments section.

The higher fruit consumption of the paleo group didn’t adversely affect glucose control, which is surprising. Fruit is supposed to raise blood sugar. At 493 grams a day, men in the paleo group ate almost seven times the average fruit intake of Swedish men (75 g/day). Perhaps lack of adverse effect on glucose control here reflects that these diabetics and prediabetics were mild cases early in the course of the condition—diabetes tends to worsen over time.

Present day paleo and low-carb advocates share a degree of simpatico, mostly because of carbohydrate restriction—at least to some degree—by paleo dieters. Both groups favor natural, relatively unprocessed foods. Note that the average American eats 250-300 g of carbohydrates a day. Total carb intake in the paleo group was 134 g (40% of calories) versus 231 g (55% of calories) in the Mediterranean-style diet. Other versions of the paleo diet will yield different numbers, as will individual choices for various fruits and vegetables. Forty percent of total energy consumption from carbs barely qualifies as low-carb.

Study participants were mild, diet-controlled diabetics or prediabetics, not representative of the overall diabetic population, most of whom take drugs for it and have much higher hemoglobin A1c’s.

Lindeberg and associates in 2009 published results of a paleo diet versus standard diabetic diet trial in 13 diabetics. Although a small trial (13 subjects, crossover design), it suggested advantages to the paleo diet in terms of heart disease risk factors and improved hemoglobin A1c. Most participants were on glucose lowering drugs; none were on insulin. Glucose levels were under fairly good control at the outset. Compared to the standard diabetic diet, the Paleo diet yielded lower hemoglobin A1c’s (0.4% lower—absolute difference), lower trigylcerides, lower diastolic blood pressure, lower weight, lower body mass index, lower waist circumference, lower total energy (caloric) intake, and higher HDL cholesterol. Glucose tolerance was the same for both diets. Fasting blood sugars tended to decrease more on the Paleo diet, but did not reach statistical significance (p=0.08).

The paleo diet shows promise as a treatment or preventative for prediabetes and type 2 diabetes. Only time will tell if it’s better than a low-carb Mediterranean diet or other low-carb diets.

Why does this matter? Five million U.S. adults have Alzheimer dementia already, and it’s going to get much worse over the coming decades.

A June, 2010, issue of Journal of the American Medical Association has a commentary by two doctors (Martha Morris, Sc.D., and Christine Tangney, Ph.D.), experts in the field of nutrition. Here’s their explanation of the NIH panel’s negative findings:

Many of the inconsistencies among studies of dietary factors can be attributed to the complexity of nutrition science and the omission of nutrition expertise in the design and analysis of both epidemiological and randomized controlled trials.

Morris and Tangney think the findings of Gu et al are valid, confirming prior studies showing benefit to diets high in vitamin E (from food) and low in saturated fat from animals. They point out that the animal foods may simply be displacing beneficial nutrients in other foods, rather than directly causing harm.

Until we have further data, anyone at risk for Alzhiemer’s may be better off following the dietary pattern above, or the Mediterranean diet. The two are similar.

Disclaimer: All matters regarding your health require supervision by a personal physician or other appropriate health professional familiar with your current health status. Always consult your personal physican before making any dietary or exercise changes.

According to Greek researchers, the components of the Mediterranean diet that contribute to longer lifespan are:

moderate alcohol consumption

low consumption of meat

high consumption of vegetables, fruits, nuts, olive oil, and legumes

The following didn’t seem to contribute much, if any:

cereals (the grain of a grass such as wheat, corn, oats)

dairy products

fish and seafood

Investigators at the University of Athens examined the Greek portion of the European Prospective Investigation into Cancer (EPIC) and Nutrition, which included 23,349 men and women free of diabetes, cancer, and coronary heart disease at the outset. Food habits were documented by questionnaire.

The focus of this particular study was death rates over an average follow-up of 8.5 years. Adherence to the traditional Mediterranean diet ranged from minimal to high, as would be expected.

As with numerous other studies of the Mediterranean diet, higher adherence to the Mediterranean diet was associated with lower chance of death.

My Comments

The lack of benefit from fish is unexpected. I have no explanation. A preponderance of evidence elsewhere suggests fish consumption helps prolong life via lowered rates of heart disease.

Links

“Do not be deceived: God cannot be mocked. A man reaps what he sows. Whoever sows to please their flesh, from the flesh will reap destruction; whoever sows to please the Spirit, from the Spirit will reap eternal life.”